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Do adjunctive statins improve periodontal treatment outcomes in patients with chronic periodontitis?
Evidence-Based Dentistry Pub Date : 2019-03-22 , DOI: 10.1038/s41432-019-0009-6
Suha Aljudaibi , Brett Duane

Data sources Medline-PubMed, Scopus and Embase databases.

Study selection Controlled clinical trials studies with at least one month follow-up that utilised locally or systemically delivered statins as a sole adjunctive treatment to mechanical periodontal therapy in patients diagnosed with chronic or aggressive periodontitis were included. Selection was carried out independently by two reviewers.

Data extraction and synthesis Data were extracted to a spreadsheet with authors being contacted for missing data. Risk of bias for randomised controlled trials was assessed using the Cochrane tool with the ROBINS-I tool being used for non-randomised studies. Weighted mean differences between baseline and six months after periodontal treatment for clinical attachment level (CAL), probing pocket depth (PPD) and intrabony defect (IBD) were calculated.

Results Fifteen studies were incorporated in the systematic review, with ten investigations included in the meta-analysis. In the meta-regression, the additional use of simvastatin, rosuvastatin and atorvastatin decreased pocket depth in contrast with mechanical periodontal treatment and a placebo gel (p < 0.05). Simvastatin and rosuvastatin significantly reduced the development of intrabony defect in contrast with control group (p < 0.05). Statins failed to provide a statistically significant difference between the adjunct therapy for both periodontal pocket depth and intrabony defect (p < 0.05). Simvastatin provided a statistically significant improvement in clinical attachment level gain, as compared to the control group (2.02 ± 0.79 mm; p = 0.043).

Conclusions Improvements in periodontal parameters were observed with the use of statins as adjunct to mechanical periodontal therapy. Simvastatin was the main medication that demonstrated additional advantages in all assessed parameters. The use of statins in relationship with non-surgical scaling and root planing provided better clinical periodontal outcomes.



中文翻译:

他汀类药物的辅助治疗是否能改善慢性牙周炎患者的牙周治疗效果?

数据源Medline-PubMed,Scopus和Embase数据库。

研究选择包括至少1个月随访的对照临床试验研究,该研究利用局部或全身给药的他汀类药物作为诊断为慢性或侵袭性牙周炎的患者的机械牙周治疗的唯一辅助治疗。选择由两名审稿人独立进行。

数据提取和综合将数据提取到电子表格中,并与作者联系以获取丢失的数据。使用Cochrane工具评估ROBINS-I工具用于非随机研究的随机对照试验的偏倚风险。计算基线和牙周治疗后六个月之间临床依从水平(CAL),探查袋深度(PPD)和骨内缺损(IBD)的加权平均差异。

结果系统评价纳入了15项研究,荟萃分析中包括10项研究。在荟萃回归中,与机械牙周治疗和安慰剂凝胶相比,辛伐他汀,瑞舒伐他汀和阿托伐他汀的额外使用减少了囊袋深度(p <0.05)。与对照组相比,辛伐他汀和瑞舒伐他汀显着减少了骨内缺损的发生(p <0.05)。他汀类药物未能在牙周袋深度和骨内缺损的辅助治疗之间提供统计学上的显着差异(p <0.05)。与对照组相比(2.02±0.79 mm; p = 0.043),辛伐他汀在临床依从性水平增加方面具有统计学上的显着改善。

结论使用他汀类药物辅助机械性牙周治疗可改善牙周参数。辛伐他汀是在所有评估参数中均显示出其他优势的主要药物。他汀类药物与非手术刮除和牙根刨光的关系可提供更好的临床牙周效果。

更新日期:2019-11-18
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